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HPV prevalence in Colombian women with cervical cancer: implications for vaccination in a developing country.

Murillo R, Molano M, Martínez G, Mejía JC, Gamboa O - Infect Dis Obstet Gynecol (2009)

Bottom Line: HPV-16/18 prevalence was 63.1%; HPV-18 had lower occurrence in the high-risk population (13.8% versus 9.6%) allowing for the participation of less common HPV types; HPV-45 was present mainly in women under 50 and age-specific HPV type prevalence revealed significant differences.Multiple high-risk infections appeared in 16.6% of cases and represent a chance of replacement.Both factors highlight the role of HPVs other than 16/18, which should be considered in cost-effectiveness analyses for potential vaccine impact.

View Article: PubMed Central - PubMed

Affiliation: Subdirección Investigaciones, Instituto Nacional de Cancerología de Colombia, Bogota, Colombia. raulhmurillo@yahoo.com

ABSTRACT
Human Papillomavirus (HPV) vaccines have been considered potentially cost-effective for the reduction of cervical cancer burden in developing countries; their effectiveness in a public health setting continues to be researched. We conducted an HPV prevalence survey among Colombian women with invasive cancer. Paraffin-embedded biopsies were obtained from one high-risk and one low-middle-risk regions. GP5+/GP6+ L1 primers, RLB assays, and E7 type specific PCR were used for HPV-DNA detection. 217 cases were analyzed with 97.7% HPV detection rate. HPV-16/18 prevalence was 63.1%; HPV-18 had lower occurrence in the high-risk population (13.8% versus 9.6%) allowing for the participation of less common HPV types; HPV-45 was present mainly in women under 50 and age-specific HPV type prevalence revealed significant differences. Multiple high-risk infections appeared in 16.6% of cases and represent a chance of replacement. Age-specific HPV prevalence and multiple high-risk infections might influence vaccine impact. Both factors highlight the role of HPVs other than 16/18, which should be considered in cost-effectiveness analyses for potential vaccine impact.

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Related in: MedlinePlus

Cervical cancer cases and related HPV infections. (a) Only HPV types counted as single infections are included. Every cervical cancer case is attributable to solely one HPV type. Cases with multiple HR-HPV infections were proportionally distributed as described in the methods section. (b) Only HR-HPV types are included. HR-LR HPV coinfections (30.6% of multiple infections) were assumed as single infections for the carcinogenic process. *LR-HPV type with single infections as described in Table 2. **HR-HPV types observed exclusively in multiple infections.
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fig1: Cervical cancer cases and related HPV infections. (a) Only HPV types counted as single infections are included. Every cervical cancer case is attributable to solely one HPV type. Cases with multiple HR-HPV infections were proportionally distributed as described in the methods section. (b) Only HR-HPV types are included. HR-LR HPV coinfections (30.6% of multiple infections) were assumed as single infections for the carcinogenic process. *LR-HPV type with single infections as described in Table 2. **HR-HPV types observed exclusively in multiple infections.

Mentions: Out of the total number of cases, 16.6% had multiple infections. Simultaneous occurrence of HPV types was present in 5% of HPV-16-associated cases, 47% of HPV-18, 14% of HPV-45, 23% of HPV-31, and 5% of HPV-58 (Figure 1). The majority of HPV-18 multiple infections were the combination with HPV-26 (Table 2). After assigning high-risk multiple infections in proportional fractions to each genotype according to the distribution of their single infections, 63.2% of cases were attributed to HPVs 16/18 (Figure 1).


HPV prevalence in Colombian women with cervical cancer: implications for vaccination in a developing country.

Murillo R, Molano M, Martínez G, Mejía JC, Gamboa O - Infect Dis Obstet Gynecol (2009)

Cervical cancer cases and related HPV infections. (a) Only HPV types counted as single infections are included. Every cervical cancer case is attributable to solely one HPV type. Cases with multiple HR-HPV infections were proportionally distributed as described in the methods section. (b) Only HR-HPV types are included. HR-LR HPV coinfections (30.6% of multiple infections) were assumed as single infections for the carcinogenic process. *LR-HPV type with single infections as described in Table 2. **HR-HPV types observed exclusively in multiple infections.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2801009&req=5

fig1: Cervical cancer cases and related HPV infections. (a) Only HPV types counted as single infections are included. Every cervical cancer case is attributable to solely one HPV type. Cases with multiple HR-HPV infections were proportionally distributed as described in the methods section. (b) Only HR-HPV types are included. HR-LR HPV coinfections (30.6% of multiple infections) were assumed as single infections for the carcinogenic process. *LR-HPV type with single infections as described in Table 2. **HR-HPV types observed exclusively in multiple infections.
Mentions: Out of the total number of cases, 16.6% had multiple infections. Simultaneous occurrence of HPV types was present in 5% of HPV-16-associated cases, 47% of HPV-18, 14% of HPV-45, 23% of HPV-31, and 5% of HPV-58 (Figure 1). The majority of HPV-18 multiple infections were the combination with HPV-26 (Table 2). After assigning high-risk multiple infections in proportional fractions to each genotype according to the distribution of their single infections, 63.2% of cases were attributed to HPVs 16/18 (Figure 1).

Bottom Line: HPV-16/18 prevalence was 63.1%; HPV-18 had lower occurrence in the high-risk population (13.8% versus 9.6%) allowing for the participation of less common HPV types; HPV-45 was present mainly in women under 50 and age-specific HPV type prevalence revealed significant differences.Multiple high-risk infections appeared in 16.6% of cases and represent a chance of replacement.Both factors highlight the role of HPVs other than 16/18, which should be considered in cost-effectiveness analyses for potential vaccine impact.

View Article: PubMed Central - PubMed

Affiliation: Subdirección Investigaciones, Instituto Nacional de Cancerología de Colombia, Bogota, Colombia. raulhmurillo@yahoo.com

ABSTRACT
Human Papillomavirus (HPV) vaccines have been considered potentially cost-effective for the reduction of cervical cancer burden in developing countries; their effectiveness in a public health setting continues to be researched. We conducted an HPV prevalence survey among Colombian women with invasive cancer. Paraffin-embedded biopsies were obtained from one high-risk and one low-middle-risk regions. GP5+/GP6+ L1 primers, RLB assays, and E7 type specific PCR were used for HPV-DNA detection. 217 cases were analyzed with 97.7% HPV detection rate. HPV-16/18 prevalence was 63.1%; HPV-18 had lower occurrence in the high-risk population (13.8% versus 9.6%) allowing for the participation of less common HPV types; HPV-45 was present mainly in women under 50 and age-specific HPV type prevalence revealed significant differences. Multiple high-risk infections appeared in 16.6% of cases and represent a chance of replacement. Age-specific HPV prevalence and multiple high-risk infections might influence vaccine impact. Both factors highlight the role of HPVs other than 16/18, which should be considered in cost-effectiveness analyses for potential vaccine impact.

Show MeSH
Related in: MedlinePlus